早期功能锻炼在急性脑卒中后肩手综合征患者中的应用

Application of early functional exercise in patients with shoulder-hand syndrome after acute stroke

目的探讨早期功能锻炼对急性脑卒中后肩手综合征患者的影响。方法2015年1月-2017年1月，前瞻性收集浙江医院收治的急性脑卒中后肩手综合征患者60例，将患者随机分为观察组和对照组，每组各30例。观察组给予早期功能锻炼，对照组仅给予常规护理，比较两组患者效果。结果干预前两组患者患肢肿胀程度、掌指关节活动度、简易上肢机能评分差异均无统计学意义（P〉0．05）。干预2、4周后观察组患肢肿胀程度均低于对照组，差异均有统计学意义（P〈0．05）。干预4周后观察组患者掌指关节活动度和简易上肢机能评分均高于对照组，差异均有统计学意义（P〈0．05）。干预前两组患者焦虑、抑郁评分差异均无统计学意义（P〉0．05）。干预4周后观察组患者焦虑、抑郁自我评分均低于对照组，差异均有统计学意义（P〈0．05）。结论早期功能锻炼可以改善急性脑卒中后肩手综合征患者患肢功能，降低焦虑和抑郁水平，改善其生活质量。

Objective To explore the effects of early functional exercise on the patients with shoulderhand syndrome after acute stroke. Methods Totally 60 patients with shoulder-hand syndrome after acute stroke who were admitted in Zhejiang Hospital between January 2015 and January 2017 were prospectively selected and randomly divided into an observation group （n=30） and a control group （n=-30）. Patients in the observation group performed early functional exercise, while patients in the control group received only routine nursing. The clinical effect was compared between the patients in the two groups. Results There was no statistically significant difference in the scores for the swelling of the limb, the range of movement of metacarpophalangeal joints and the simple upper limb function before the intervention （P 〉 0.05）. After two weeks and four weeks of intervention, the swelling of the limb in the patients in the observation group was lower than that of the patients in the control group （P 〈 0.05）. After four weeks of intervention, the scores for the range of movement of metacarpophalangeal joints in the patients in the observation group were higher than those of the patients in the control group （P 〈 0.05）. There was no statistically significant difference in the scores of anxiety and depression between the patients in the two groups （P 〉 0.05）. After four weeks of intervention, the patients in the observation group showed lower scores of anxiety and depression than the patients in the control group （P〈0.05）. Conclusions Early functional exercise helps to improve the function of limbs, lower the level of anxiety and depression, and improve the quality of life in patients with shoulder-hand syndrome after acute stroke.